Utilization of Buccal Fat Pad in Combination with Adjacent Soft Tissue Flap for Closure of Large Oro-antral Communication in the Elderly

doi:10.13701/j.cnki.kqyxyj.2024.04.008

Abstract

Abstract: Objective: To investigate the application of buccal fat pad (BFP) combined with adjacent soft tissue flap in management of large oro-antral communication (OAC) in the elderly. Methods: Eight patients with intraoperative large OAC (maximum diameter greater than 4 cm) admitted to the Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Medical School, Nanjing University from January 2020 to December 2022 were collected, and the age of the patients ranged from 62 to 84 years old. The application of BFP combined with a buccal advancement flap or a palatal mucosal flap to cover the defect was retrospectively analyzed, and the efficacy was prospectively evaluated during postoperative follow-up. Results: All cases were successfully repaired, and no flap necrosis, perforation, infection, or maxillary sinusitis was found. The maxillofacial region was basically symmetrical during the 3-month follow-up. After mouth opening training, the mouth opening returned to normal. Conclusion: BFP combined with adjacent soft tissue flap is a convenient and reliable method to repair large OAC in the elderly, and is worthy of clinical promotion.

Key words: the elderly, oro-antral communication, buccal fat pad, adjacent soft tissue flap

XU Zedong, SUN Guowen. Utilization of Buccal Fat Pad in Combination with Adjacent Soft Tissue Flap for Closure of Large Oro-antral Communication in the Elderly[J]. Journal of Oral Science Research, 2024, 40(4): 321-324.

References

[1] Egyedi P. Utilization of the buccal fat pad for closure of oroantral and/or oronasal communications [J]. J Maxillofac Surg, 1977, 5(4):241-244.
[2] Mannelli G, Arcuri F, Comini LV, et al. Buccal fat pad: Report of 24 cases and literature review of 1,635 cases of oral defect reconstruction [J]. ORL J Otorhinolaryngol Relat Spec, 2019, 81(1):24-35.
[3] Chouikh F, Dierks EJ. The buccal fat pad flap [J]. Oral Maxillofac Surg Clin North Am, 2021, 33(2):177-184.
[4] Adams T, Taub D, Rosen M. Repair of oroantral communications by use of a combined surgical approach: functional endoscopic surgery and buccal advancement flap/buccal fat pad graft [J]. J Oral Maxillofac Surg, 2015, 73(8):1452-1456.
[5] 张晔,金建秋,苑绪光,等.颊脂垫修复口腔上颌窦瘘[J].口腔颌面修复学杂志,2016,17(4):229-231.
[6] 李晨曦,帕热克江·帕塔尔,于鹏,等.利用颊脂垫的三明治修复技术即刻修补口腔上颌窦瘘[J].口腔颌面修复学杂志,2022,25(3):144-149.
[7] Parvini P, Obreja K, Sader R, et al. Surgical options in oroantral fistula management: a narrative review [J]. Int J Implant Dent, 2018, 4(1):40.
[8] 任宇轩,马振,马洋,等.106例拔牙导致口腔上颌窦交通的临床分析[J].口腔医学,2021,41(2):149-153.
[9] Tideman H, Bosanquet A, Scott J. Use of the buccal fat pad as a pedicled graft [J]. J Oral Maxillofac Surg, 1986, 44(6):435-440.
[10] Arce K. Buccal fat pad in maxillary reconstruction [J]. Atlas Oral Maxillofac Surg Clin North Am, 2007, 15(1):23-32.
[11] Bereczki-Temistocle DL, Gurzu S, Jung I, et al. Selecting the best surgical treatment methods in oro-antral communications [J]. Int J Environ Res Public Health, 2022, 19(21):14543.
[12] Melville JC, Tursun R, Shum JW, et al. A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: the combined buccal fat pad flap and radical sinusotomy [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2016, 122(3):287-291.
[13] Batra H, Jindal G, Kaur S. Evaluation of different treatment modalities for closure of oro-antral communications and formulation of a rational approach [J]. J Maxillofac Oral Surg, 2010, 9(1):13-18.
[14] 于森,王洋,毛池,等.1107例上颌骨缺损的临床分类及修复方法分析[J].北京大学学报,2015,47(3):509-513.
[15] 石亮,许辉,卡米力江·买买提明,等.邻近组织瓣即刻修复老年人侧面部肿瘤切除后软组织大面积缺损策略探讨[J].中华整形外科杂志,2021,37(8):847-855.
[16] Nelke K, Morawska A, B łaszczyk B, et al. Anatomical and surgical implications of the usage of bichat fat pad in oroantral communication, maxillary, palatal, and related surgeries-narrative review [J]. J Clin Med, 2023, 12(15):4909.
[17] Mannelli G, Arcuri F, Comini, LV, et al. Buccal fat pad: Report of 24 cases and literature review of 1635 cases of oral defect reconstruction [J]. ORL J Otorhinolaryngol Relat Spec, 2019, 81(1):24-35.
[18] Arana-Ferníndez B, Santamaría-Gadea A, Almeida-Parra F, et al. Oroantral fistula closure using double-layered flap: Greater palatine artery flap and buccal fat pad [J]. Laryngoscope, 2023, 133(8):1824-1827.
[19] Liu YM, Chen GF, Yan JL, et al. Functional reconstruction of maxilla with pedicled buccal fat pad flap, prefabricated titanium mesh and autologous bonegrafts [J]. Int J Oral Maxillofac Surg, 2006, 35(12):1108-1113.